Provider Demographics
NPI:1508890625
Name:JCS MEDICAL ASSOCIATES PLC
Entity Type:Organization
Organization Name:JCS MEDICAL ASSOCIATES PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-723-1910
Mailing Address - Street 1:3190 N MCMULLEN BOOTH RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761
Mailing Address - Country:US
Mailing Address - Phone:727-723-1910
Mailing Address - Fax:727-723-1920
Practice Address - Street 1:3190 N MCMULLEN BOOTH RD
Practice Address - Street 2:SUITE 203
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761
Practice Address - Country:US
Practice Address - Phone:727-723-1910
Practice Address - Fax:727-723-1920
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JCS MEDICAL ASSOCIATES PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-11
Last Update Date:2007-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74378173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG77604Medicare UPIN
FLG77606Medicare UPIN
FLK3315Medicare ID - Type UnspecifiedGROUP NUMBER